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Single-step transepithelial versus alcohol-assisted photorefractive keratectomy in the treatment of high myopia: a comparative evaluation over 12 months
  1. Rafic Antonios1,
  2. Maamoun Abdul Fattah1,
  3. Samuel Arba Mosquera2,3,4,
  4. Bachir H Abiad1,
  5. Karim Sleiman1,
  6. Shady T Awwad1
  1. 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
  2. 2Department of Research and Development, Schwind Eye-Tech-Solutions, Kleinostheim, Germany
  3. 3Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain
  4. 4Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo, Spain
  1. Correspondence to Dr Shady T Awwad, Department of Ophthalmology, American University of Beirut Medical Center, Cairo St, PO Box 110236, Beirut 110236, Lebanon; sawwad{at}gmail.com

Abstract

Background/aims To evaluate refractive outcomes of single-step transepithelial photorefractive keratectomy (TransPRK) versus alcohol-assisted PRK (EtOH-PRK) for the correction of high myopia.

Methods This was a retrospective non-randomised comparative study conducted at the American University of Beirut Medical Center, Beirut, Lebanon. Eyes with myopia (spherical equivalent (SE) larger than −6.00 D) that had undergone EtOH-PRK treatment combined with mitomycin C and TransPRK (SE: −7.53±0.90 D and −7.24±0.77 D, p=0.062), using the Schwind Amaris excimer laser, were included. 59 eyes (37 patients) that had single-step TransPRK were compared with 59 eyes (36 patients) that had EtOH-PRK. Visual and refractive outcomes, including analysis of astigmatism, and corneal higher order aberrations (HOAs) at 6.0 mm optical zone, were compared for 12 months postoperatively.

Results Baseline characteristics were similar between the two groups (p>0.05). The SE deviation from target (SEDT) at 1 week, 1, 3, 6 and 12 months follow-up visits were similar between groups (p=0.428). At 12 months, 81.3% and 73.3% of eyes that had undergone TransPRK and EtOH-PRK, respectively, were between ±0.50 D SEDT (p=0.381). Mean cylinder power was 0.33±0.26 D versus 0.41±0.30 D at 12 months follow-up (p=0.140). The mean success index was 0.50±0.50 for the TransPRK group and 0.49±0.52 for the EtOH-PRK group (p=0.939), while the absolute mean angle of error was 7.81°±61.98° vs 13.12°±71.86° (p=0.667), respectively. The change in total, spherical and comatic corneal HOAs were similar in both groups at 12 months (p>0.05). Haze was similar between both groups; two eyes had +1 haze at 12 months in the TransPRK group versus zero eyes among the EtOH-PRK group (p=0.154).

Conclusions Single-step TransPRK for high myopia with or without astigmatism appears to yield similar visual, refractive and safety results as EtOH-PRK.

  • Cornea
  • Ocular surface
  • Optics and Refraction
  • Treatment Lasers
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Footnotes

  • Contributors STA, RA and MAF were involved in the study design, acquisition, analysis and interpretation of data for the work. Also in drafting and writing the work and revising it critically for important intellectual content and final approval of the version to be published. SAM was involved in acquisition, analysis and interpretation of data for the work. Also in drafting the work and revising it critically for intellectual content and final approval of the version to be published. BHA was involved in acquisition, analysis and interpretation of data for the work. Also reviewed and revised the final manuscript critically and final approval of the version to be published. KS was involved in analysis and interpretation of data for the work. Also reviewed and revised the final manuscript critically and final approval of the version to be published.

  • Funding The study did not receive external funding.

  • Competing interests SAM is an employee of Schwind Eye-Tech Solutions.

  • Ethics approval Institutional Review Board (American University of Beirut).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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